474 NE 94 St (7)Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reque
Date
Typelnsp'n CIL
Permit No. I-46 20(53 22S
Ng2
414 NE, q s+
UnOed eQS }
E5l£s- 7C3- 2 53
enfr 100
t1e-8104
BUILDING
PERMIT APPLICATION
FBC 2001
Tenant/Lessee Name
$ Value of Work For this Permit
Miami Shores Village
Building Department
sz'
Permit Type (circle): Building Electrical Plumbing
Roofing
Owner's Name (Fee Simple Titleholder) S �CP / � Z - Phone # (log) - 7/ Fa
Owner's Address 447Y- Nc 9 S f
City IM (A-in ( S/4i - S State P
Master Permit No.
Zip 33 Off
Phone #
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
J
Permit No. 1-4 225 OJr
Job Address (where the work is being done) 47 9c/ Sf
City Miami Shores Village County Miami -Dade Zip 33 t 3 S
Is Building Historically Designated YES NO
•
Contractor's Company Name Vii / Phone #
Contractor's Address 58 r9 N r .71 , e_
City State e r Zip
Qualifier SLOP 5-C64 t T
Architect/En Name (if applicable) - Phone #
Architect/Engineer's Address
City State Zip
Square Footage Of Work:
Baths
Number of: Bays Stories Families Bedrooms
Type of Work: ❑Addition
:Alteration :New Repa 'liplace 0 Demolition
���/ !� � � ,z
Describe Wo k: K/ � Ad-- 0 ( ' - GFGU 7 ` /eGe 4 C 4 r-
`/Y10Di& Pi) 1,446 4x04 c �)
PRAINA 0 `f8O
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ SO P c _ v Z-1 is Permit Fee $ 4f (,— Notary $
Education/Training Fee $ .. 4 f) Tech $ "1 Scanning $ Radon $
Code Enforcement $ / f. ,, Bond $ Struct. $
6 / y_ C (Continued on opposite side)
Minus Plans Check Fee _ =;° _ e, Total Fee Now Due $ C �-`%�
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspec 1, • , t be approved and a reinspection fee will be charged.
Signa
C
�IIY Q COMMISSION M;MP. R
*Quit � * F * * *
MY cammLSSION *#r�k rWWat
P
p,RY PV OFFICIAL NOTARY SEAC
•
NOTARY
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * **
:hc717 /03
wner or Agent
5a
Signature
NOTARY PUBLIC.
Sign:.
Print:
My Commission Expires:
Zip
The '! going instrument was acknowledged b ore me this /5 The foregoin instrument was acknowledged before me this /J
day o ' °, 2P.S, byckiSfi . n
day of 2G 3 by -- oi
who is personally known to me or who has produced
who is personally known to me or who has produced
As 'dentification and who did take an oath.
/ as identific • 'on and who did take an oath.
****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
,� (Certificate of Competency Holder)
�}
State Certificate or Registration No 0.4 d- /5 ,
Certificate of Competency No.
APPLICATION APPROVED BY:
Plans Examiner + -.-- C7 1
Engineer
Zoning
iEM
4TH 1113
UNIT
FEE
ITEM .
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE •
IDET
LIGHT OUTLETS
CENTRAL HEATING
ISHWASHER
RECEPTACLES
A/C (WIND)
ISPOSAL
SERVICE TEWORARY
A/C (CENTRAL)
'I
SINKING FOUNTAIN
SERVICE SIZE IN AMFS
DUCT WORK
LOOK DRAIN
SERVICE REPAIR/ TER CHANGE
REFRIGERATION
REASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
AVATORY
OVEN
ABOVE GROUND TANKS
AUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
LOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
.HOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
:INK, POT /3 COMP.
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION
:INK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
:INK, SLOP
MOTORS OVER 8- 10 If
ELEVATORS/ESCALATORS
'EMPORARY WATER CLOSET
MOTORS OVER 10- 25 If
FIRE SPRINKLER SYSTEMS
JRINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
iATER CLOSET
MOTORS OVER 100 If
VIOLATION
NDIRECT •WASTES
A/C WINDOW
RE INSPECTION
LATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
'HEATER -NEW INST.
GENERATORS TRANSFIIiMiERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
'
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
JTILITY -SEWER
SIGN TIME CLOCK
JTILITY -WATER
FIXTURES
;EPTIC TANK
ANTENNA
IELAY
TELEVISION OUTLETS
)RAINFIELD, 4' TILE/RES.
VIOLATION
'LIMP & ABANDON SEPTIC TANK
REINS?ECTION
SOAKAGE PIT CU. FT.
;ATCH BASIN
)ISCHARGE WELL
)OMESTIC WELL
AREA DRAIN
300F INLET
•
SOLAR WATER HEATER ,,
=IRE STANDPIPE
'OOL PIPING
•
_AWN SPRINKLER SYSTEM
3AS RANGE
DETER SET (GAS)
3AS PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED.,' THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /19/2003
Applicant: JOSEPH PERZ
Owner: PERZ JOSEPH
JOB ADDRESS: 474 NE 94 ST
Contractor UNITED RESTORATION
Local Phone: 954 - 771 -6466
Parcel # 1132060140310
Signed: (INSPECTOR)
Mechanical Permit
Permit Number: ME2003 -225
Contractor's Address: 5819 N ANDREWS WAY
Permit Status: APPROVED Permit Expiration: 6/13/2004 Construction Value: $2,800.00
Work: CHANGE EXISTING A/C
Page 1 of 1
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 3 & E1/2 LOT 4 BLK 51 LOT SIZE 75.000
Fees: Description Amount
FEE2003 -8482 Building Fee $106.00
FEE2003 -8483 CCF $1.80
FEE2003 -8484 Training and Education Fee $0.60
FEE2003 -8485 Technology Fee $2.65
Total Fees: $111.05
Total Fees: $ 1 .g,0
Total Receipts: 10.00
,),, ,c, I t (2s
DEC 2 3 PAID --
DEC 2 2 PAID
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
MIAMI SHORES VI
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reque
Date `D / t
Type Insp'n
Permit No. 2 -004 v 22,
Name a)\ .
Address 4 4 l AV , 014
Company s ��
Phone #
Inspection Date
Approved
Correction ❑
Re- Insp'n Fee ❑
. 1 CI 3..3
MIAMI SHORE VILLT GET
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reque t
Date =7 / ev
Type Insp'n, tE c t
32Z Permit No. r e e P ` ' ,
Name \ � e
Address 4 We •` \
Company J ( )11 CA S
1, Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
ADDRESS 474 I. E. 94th St. LEGAL" 56,,,
RECORD GARBAGE TAX
PAID BY 1
YEAR
ANNUL TAX
PERIOD USED
AMOIANT PAID
DATE PAID
NUMBER
M. P.. z1Trtt R (0 3 S 3 a
1950
12.00
12 -31 -50
3.00
D-4 -55
15315
/97/
i 70d - aV
04/5
/o? .3/•5/
/ owl. e-I,
/- // - -1 -
�rtr > 1
e, j. DeNo \r co (e) 7 -,o -sl
/S
/ ° °
47-93/-S.,--
/ %
, - ..
.( ot 3 YE" / 4o1Y ,7, s!
o a, (032
Application is hereby made for the approval of the detailed statement or me plans and specifications herewith submitted for the build •
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miarni
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progreu of the work.
Date... —(I! ... f Z _.._�..._._ 19.g_
Owner's Name and Address ... .�C . `1'14 A.R. p .... • ._ No... 4 Street.t'V..� ( 29' _Tl ..._.
Registered Architect and /or Engineer s tttt 33 138
co 3 / NG
Name and address of licensed contractor..Q.�� �� ..�s .
: � .... _4 400 (.v v � �.._... �. ..... ....7.�..� ......_.._..__
Locatio and Ip al of lot to be built on: /j Q /
Lot NI + �y Block � l Subdivision.. : / 1 � ' .... // s � q 1� .._j ..... d3/0 T......_..
Street and Number where work is to be done
State work to be done and purpose of building (by floors) ...__t L.).. S . T..ir). -4-
At g - c o .p .. � . w l cT SYS:Teel PA-Lw S ,.... 5 f o t, Cj
. 0 N 0 U ART 3T0 7 (- g A(R. dfll N DL 6-4Q- B w t7( g 461.- "4 and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost ol; improvements $ 2,. Gd Amount of Permit $.
lone cubage required plan Cubage
Distance .to next ne.uest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to..
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Sopffuleuuent,
and has complied with the provisions thereof, and will require similar compliance frrun all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such ntractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks... (Signed)
STATE OF FLORIDA.
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fads
therein by him stated are true.
Permit No.._. 01 _ ( Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date.
PLANNING BOARD DATE
Chairman Member
\icrr:ber Member
c'A‘c- 2 ? a
Notary Public, State of Florida
Building Inspector My Commission Expires
to me well known,
\tembcr .. .. _....-- .--- ._..._._ ...._ Member ...._ �.._._..._...... __.. _...._
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after apprmal has been obtained from
the Pl.innir•g Board.
A re tion fee of $L00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.